Conservative treatments for greater trochanteric pain syndrome: a systematic review

Greater trochanteric pain syndrome: a review of diagnosis and management in general practice

“…Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain, seen more commonly in females between the ages of 40 and 60. 1,2 GTPS is the cause of hip pain in 10-20% of patients presenting with hip pain to primary care, with an incidence of 1.8 patients per 1000 per year. [1][2][3] Traditionally thought to be due to trochanteric bursitis, surgical, histological, and imaging studies have shown that GTPS is attributable to tendinopathy of the gluteus medius and/or minimus with or without coexisting bursal pathology.…”

Conservative management of lateral hip pain: the future holds promise

“…In the systematic review regarding greater trochanteric pain syndrome (GTPS) Barratt et al 1 found only eight non-surgical treatment studies eligible for review. Of these, all but one had a moderate-to-high risk of bias.…”

“…While acute complications following CSI are rare, concerns remain regarding potential negative effects on the tendon associated with down regulation of fibroblastic production of collagen and tissue necrosis following repeated injections. Barratt et al 1 also raise the legitimate concern regarding the paucity of documentation of medical advice accompanying CSI. Considering CSI does not address the aetiological mechanisms underlying painful tendinopathy, the concomitant advice may well have a substantial impact on the outcome of the intervention.…”

“…Barratt et al 1 discuss the only two other trials currently available for GTPS investigating—(a) extracorporeal shockwave therapy (ESWT) and (b) home exercise. While ESWT provides promising medium-term outcomes, long-term results show no advantage.…”

“…Examination of the usefulness of these tests in the diagnosis of symptomatic gluteal tendinopathy may assist in the future standardisation of diagnostic criteria for lateral hip pain studies. Use of condition-specific outcome measures, such as the VISA-G (web appendix) was also recommended by Barratt et al 1 The LEAP trial has employed the VISA-G score as well as a number of other patient reported outcome measures. Further exploration of outcome measures for lateral hip pain will be beneficial in determining which are most useful in defining various impairments and most sensitive to change over time and in response to an intervention.…”